Alignment Healthcare and Heal partner to offer members in-home primary care

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At the start of this year, there was a rule change in Medicare that allowed house calls to be delivered to all of America’s approximately 50 million Medicare patients, rather than just those that are medically home bound.

This was a major boon for a company like Heal, a provider of doctor house calls, and which helped spearhead the rule change. On the back of that change, the company recently expanded its services to New York City, and now the Los Angeles-based company is looking to expand to the Medicare population in its home market as well.

That's why the company announced Thursday that it has partnered with Alignment Healthcare, an Orange County-based insurance company that serves Medicare Advantage members.

"The partnership with Alignment is one of many insurance partnerships we’ve done, but it’s special because Alignment is a very innovative Medicare Advantage plan. There are a lot of good Medicare Advantage plans, there’s a lot of not good ones, but Alignment is specifically designed by bright, innovative people who are healthcare veterans and who have created a plan that has both the technology interfaces, as well as the features, that together with Heal deliver a much more comprehensive experience to the member," Nick Desai, co-founder and CEO of Heal, told me in an interview.

Founded in 2013, Alignment goes beyond only offering standard benefits to its members; it also has its ACCESS On-Demand Concierge program and black card programs, which gives members a dedicated concierge team and a debit card that can be used for qualified items, such as groceries at 50,000 retailers, as well as transportation to appointments through Uber and Lyft, and companion care. The company also has a program called "Grandkids on-demand", where college students assist member in non-medical tasks, like household chores. 

It's these kinds of programs, Desai said, that make Alignment a special partner for a company like Heal.

"When you talk about Medicare Advantage members, and half of Medicare members live on a fixed income of under $35,000 a year, you’re talking about people who really need those kinds of services. So, putting Heal and Alignment together is a perfect marriage of a great plan and a great primary care program that can help members achieve better health by having more services that they need available to them," he said.

For Alignment, giving their members access to Heal will expand a type of service that it was already offering, but only to its sicker members, said Dawn Maroney, consumer president at Alignment Healthcare. Heal will be able to offer a full primary care service to all of Alignment's members. 

"We do care in the home currently today; we typically do it for a certain subset or a demographic population, across all of our markets, and we do it extremely well. What we want to do, and where Heal comes to table, is to do concierge-type care for seniors, including those that are very active and need primary care services but they’re too busy or they’re home bound and they need primary care in the home," she told me

"The great thing about Heal is they offer that full primary care, so we believe, from the results that they’ve shared with us through their net promoter score, that people are very satisfied with it." 

Right now, Alignment is covering around 60,000 to 65,000 patients, and both companies believe that the number who will take advantage of having Heal as a benefit will eventually number in the thousands.

"It’s going to be phenomenal for Heal once we get this right, and we’re really excited to be the first plan for them in California to do it. They’ve got a great vision, they’ve got phenomenal net promoter scores. The fact that when somebody needs an appointment that they can do it in a couple of hours, it’s pretty powerful," said Maroney. 

"Once it starts going, it should get into the thousands. We know that, currently to date, we have over 3,000 or 4,000 people that get care from our existing doctors in the home, so to have full primary care it should be big." 

A successful partnership between Heal and Alignment, Desi said, will mean that Heal becomes the first choice for primary care among Alignment’s members.

"What success looks like is that we we are exceeding their quality and cost savings targets. One of the things that I always like to say is that the only real way to lower healthcare costs is to improve outcomes. If you lower healthcare costs by robbing people of benefits, of not covering a medication, all that means is they put off care from today to tomorrow, then they get sicker and it costs more, and that’s not good," he said.

"The true measure of success is, simply put, is that people are leading happier, healthier lives, that they are spending less time getting well and more time being well and they cost significantly less to Medicare, to Alignment and the member."

"Success means living up to our promises. If we say we’re going to deliver a doctor who will be in your home for two to four hours, then that doctor will be in your home for two to four hours. That the patient feels safe and that, at the end of the day, we have minimum net promoter score greater than 65. That's success," said Maroney.